The disclosure relates to a fine tuning system and method which are in particular used in connection with after-sales support for the purchaser of medical devices such as hearing aids. The fine tuning system and method may however also be used in connection with other medical consultations which empirically run through the same standard stages, as for example pregnancy counselling or the counselling during certain stages of cancer treatment, which do not necessarily require the personal visit to the doctor each time. It is also conceivable that the proposed fine tuning system and process may also be applied in the economical field in cases where certain routine steps are likely to occur, e.g. in connection with real estate purchase.
However, for the purpose of comprehensive explanation it is referred in the following to the field of use of hearing aids.
Firstly, with regard to the nature of the hearing loss, it is noted that a hearing loss correction with hearing aids is the only sensorial correction performed today on a routine basis.
Typically, any human being over thirty years of age has a somewhat reduced hearing performance. The hearing performance diminishes gradually as part of the aging process and usually reaches at an age of around sixty to seventy years a level where the ability to understand others is significantly impaired, especially in noisy environments.
On the average, the cochlea—i.e. the auditory portion of the inner ear—has more than 23.000 hair cells that die off and never grow again as part of the natural aging process and modern life environment (hair cells are very sensible to loud noises).
It is commonly known that for people who have already lost significant amounts of their hair cells, the only available solution is the use of hearing aids. However, this may not resolve the origin of the problem, namely that the hair cells do not grow again. Rather, the hearing aid may only compensate for some of the effects, i.e. the hearing loss.
The human hearing system operates according to the principle of comparing and matching the sound heard with the sound impressions stored in the brain. Thus, the human hearing system may be regarded as a kind of “brain dictionary” which is acquired as part of the normal learning process. Therein, matching results on words and concepts are (correctly) understood. Yet, sometimes, when the wrong association is established, the (non-matching) words and concepts are misunderstood.
Since the human brain is highly adaptable, it constantly updates the stored sound impressions in order to broaden its capabilities and in order to be able to adapt to new respectively changing sound impressions.
Once the individual starts losing his hearing abilities, his brain quickly adapts the “brain dictionary” in order to maintain the understanding performance. However, since the degradation of the hearing abilities is progressive, the individual will reach at some point a poor level of understanding, even with this adaptation. This is the moment, where the individual will start looking for help, i.e. usually in form of a hearing aid, being one of the few possibilities.
It is worth mentioning that it usually takes an individual approximately twelve years from the moment he recognizes that he has a hearing problem up to the time he actually buys a hearing aid. Since during these years the brain has been working actively to create a new “brain dictionary” (i.e. in order to compensate for the hearing problems), it takes several months for the brain to generate the code for the new hearing impression once a proper hearing is re-established (i.e. with the help of the hearing aid).
This process can be very frustrating for the new user of the hearing aid because on the one hand he will hear much more than before, but on the other hand he may understand much less—despite his new and relatively expensive device.
Constant use of the device and perseverance are the key factors in this part of the process where it is highly important to assist the brain in creating the new code and thus achieving the expected level of understanding.
Thus, in the following, today's hearing aid fitting process is briefly described and divided up into its five basic working steps:    (1) Lead generation: this step includes all the tasks planned and executed that have as main objective to raise interest of potential buyers and induce them to contact a point of sales/an organization in order to gather more information.    (2) Lead conversion: this step includes all the tasks planned and executed that have as main objective to convert the interest of the potential buyer into an actual transaction.    (3) Fitting: this step includes all the tasks regarding diagnostics, evaluation, solution selection and initial activation of such solution adapted to the individual needs of the person with the hearing disability.    (4) Fine tuning: this step includes all the tasks performed after the fitting step to further adapt the use and performance of the solution to the objective and subjective needs of the user.    (5) After sales service: this step includes all the tasks executed to maintain the intended performance of the device once in daily use.
In the technical field, there is a desire to optimize the way of performing in particular the fine tuning and also the after-sales steps of the hearing aid fitting process.
Typically, a full fitting process (including lead conversion, fitting and fine tuning) can take up to fifteen hours. In many cases, the end user comes back up to six times after fitting until either he is satisfied, gives up or returns the instrument for credit.
Return for Credit (RfC) can be as high as 14% of total sales. Typically, the RfC costs an average store up to 1500 USD per ear (in direct cost), not considering recurrent revenues for the same customer which will be lost as well. It is noted in this context that on the average, customers return up to 2.5 times for repurchase during their lifetime.
It has to be considered that the effort of calling the store for an appointment, going to the store, waiting for the appointment, the appointment itself, the costs (in time and emotions) of those six visits after fitting etc., is significant, both for the practice and for the end consumer and generates a significant amount of frustration on both sides. It is worth mentioning that the after-fitting visits of the patient are free of charge and thus represent a direct cost for the store.
In the following, the challenges in today's fitting process are described in more detail.
Typically, after a normal first fitting session, the hearing aid instrument is already programmed for the particular need of the end user. Before leaving, the end user is instructed on several procedures e.g. how to clean his instrument, change the battery, put the instrument into the ear etc. The end user also gets a general guidance on what he can expect from his new instrument and how to deal with the different daily sound environments.
Very often the end user gets various leaflets with general counseling on how to tackle his first experiences with the new hearing aid instrument.
However, it has to be considered that on the one hand this is a lot of new information for a person (often) over seventy years of age and that on the other hand this person is getting most of the counseling in verbal form trough a new instrument that he is not yet used to.
Since initially the results achieved with the new instrument are rather poor, most audiologists ask the end users to come back after a few days to go again through the instructions and to motivate the end user to keep using his new hearing aid. Very often however, the end user is somehow disappointed once he experiences that the understanding is not perfect right away (i.e. there is a gap between expectations and reality).
It is noted that it is rather seldom that the audiologist needs to do some reprogramming changes on the instruments, since it has been found that it is not beneficial to change too much of the initial sound impression in order to keep the learning process as simple as possible. As mentioned before, on the average, an end user comes back up to six times into the store in these first three months, and up to 14% of the end users claim their money back (i.e. the gap between expectations and reality could not be closed).
According to today's practice, there is altogether very little ownership of the adaption process on the side of the end user since it is typically believed that he has bought a device which has to perform by itself.